Provider Demographics
NPI:1972013175
Name:KAMI HOSS, D.D.S. INC.
Entity Type:Organization
Organization Name:KAMI HOSS, D.D.S. INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:TAYLOR
Authorized Official - Middle Name:S
Authorized Official - Last Name:MOTA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:619-737-7700
Mailing Address - Street 1:9737 AERO DR
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92123-1859
Mailing Address - Country:US
Mailing Address - Phone:619-591-2657
Mailing Address - Fax:
Practice Address - Street 1:2226 OTAY LAKES RD
Practice Address - Street 2:
Practice Address - City:CHULA VISTA
Practice Address - State:CA
Practice Address - Zip Code:91915-1010
Practice Address - Country:US
Practice Address - Phone:619-216-7846
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-10-03
Last Update Date:2017-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA410161223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty